Organization
MALECON PHARMACY INC
Active
Other names
MALECON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREY SOLOVYEV (PRESIDENT)
(305) 558-8551
Entity
Organization
Contact information
Practice address
5966 W 16TH AVE, HIALEAH, FL 33012-6814
(305) 558-8551
(305) 558-8512
Mailing address
5966 W 16TH AVE, HIALEAH, FL 33012-6814
(305) 558-8551
(305) 558-8512
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH6079
FL
3336M0003X
Managed Care Organization Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003039900
—
FL
05
—
103293300
—
FL
05
—
103293301
—
FL
01
—
2004325
PK
—
Enumeration date
01/30/2007
Last updated
04/07/2016
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